levetiracetam and Opsoclonus-Myoclonus-Syndrome

Opsoclonus-myoclonus-ataxia syndrome is a heterogeneous constellation of symptoms ranging from full combination of these three neurological findings to varying degrees of isolated individual sign. Since the emergence of coronavirus disease 2019 (COVID-19), neurological symptoms, syndromes, and complications associated with this multi-organ viral infection have been reported and the various aspects of neurological involvement are increasingly uncovered. As a neuro-inflammatory disorder, one would expect to observe opsoclonus-myoclonus syndrome after a prevalent viral infection in a pandemic scale, as it has been the case for many other neuro-inflammatory syndromes. We report seven cases of opsoclonus-myoclonus syndrome presumably parainfectious in nature and discuss their phenomenology, their possible pathophysiological relationship to COVID-19, and diagnostic and treatment strategy in each case. Finally, we review the relevant data in the literature regarding the opsoclonus-myoclonus syndrome and possible similar cases associated with COVID-19 and its diagnostic importance for clinicians in various fields of medicine encountering COVID-19 patients and its complications.

Topics: Adult; Anticonvulsants; Ataxia; Azithromycin; Clonazepam; Cough; COVID-19; COVID-19 Drug Treatment; Dyspnea; Female; Fever; Humans; Hydroxychloroquine; Levetiracetam; Male; Middle Aged; Myalgia; Opsoclonus-Myoclonus Syndrome; Oseltamivir; SARS-CoV-2; Valproic Acid

In this rare case, the patient presented with opsoclonus, myoclonus and ataxia. Serological and imaging studies revealed high glutamic acid decarboxylase antibody (GAD-Ab) levels. High-dose corticosteroids were of no benefit and subsequent intravenous immunoglobulin (IVIg) administration proved resolution of the condition. Levetiracetam proved useful in symptomatically controlling the myoclonus. Follow-up GAD-Ab levels were within normal limits.

Topics: Adult; Anticonvulsants; Anxiety; Ataxia; Autoantibodies; Diagnosis, Differential; Earache; Female; Follow-Up Studies; Glutamate Decarboxylase; Headache; Humans; Immunoglobulins, Intravenous; Lethargy; Levetiracetam; Meningoencephalitis; Opsoclonus-Myoclonus Syndrome; Piracetam; Treatment Outcome

Topics: Aged; Anti-Bacterial Agents; Anticonvulsants; Cefepime; Electroencephalography; Female; Headache; Humans; Levetiracetam; Opsoclonus-Myoclonus Syndrome

A 60-year-old man presented with a 25-day history of acute onset instability of gait, tremulousness of limbs and involuntary eye movements. Examination revealed presence of opsoclonus, myoclonus and ataxia, without any loss of motor power in the limbs. Prompt investigations were directed towards identifying an underlying malignancy which is often associated with this type of clinical scenario. CT of the brain was normal and cerebrospinal fluid examination showed lymphocytic pleocytosis. A cavitatory lesion was found in the right lung base on the high-resolution CT of the chest and histopathological examination of this lung mass showed small cell lung carcinoma. The patient was managed symptomatically with levetiracetam and baclofen and referred to oncology department for resection of the lung mass.

Topics: Baclofen; Humans; Levetiracetam; Lung; Lung Neoplasms; Male; Middle Aged; Muscle Relaxants, Central; Opsoclonus-Myoclonus Syndrome; Piracetam; Radiography; Small Cell Lung Carcinoma